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目的比较多西他赛联合奈达铂与多西他赛联合顺铂治疗晚期非小细胞肺癌(NSCLC)的近期临床疗效和安全性。方法 62例NSCLC患者随机分为多西他赛联合奈达铂组(DN组)32例和多西他赛联合顺铂组(DP组)30例。21d为1周期,治疗2周期后,评估近期疗效和安全性。结果近期疗效方面:两组有效率分别为DN组56.3%和DP组50%,差异无统计学意义(P>0.05)。安全性方面:骨髓抑制:Ⅲ-Ⅳ度血小板减少出现率DN组25%(8/32)明显高于DP组10%(3/30)(P<0.01)。消化道反应:DN组恶心呕吐出现率25%(8/32),明显低于DP组76.7%(23/30)(P<0.01);肾脏毒性:肾脏损害出现率DN组6.3%(2/32)明显低于DP组20%(6/30)(P<0.01);Ⅲ-Ⅳ度肾脏损害出现率DN组3.1%(1/32)明显低于DP组13.3%(4/30)(P<0.01)。结论多西他赛联合奈达铂与多西他赛联合顺铂治疗晚期非小细胞肺癌近期临床疗效相似,毒副作用DN组主要为骨髓抑制,DP组主要为消化道反应和肾脏毒性。临床使用中,可根据患者的个体差异考虑毒副反应,选择用药。
Objective To compare the short-term clinical efficacy and safety of docetaxel combined with nedaplatin and docetaxel plus cisplatin in the treatment of advanced non-small cell lung cancer (NSCLC). Methods Sixty-two patients with NSCLC were randomly divided into docetaxel combined with nedaplatin group (DN group) 32 cases and docetaxel plus cisplatin group (DP group) 30 cases. 21d for 1 cycle, after 2 cycles of treatment to assess the recent efficacy and safety. Results In the short term, the effective rates of the two groups were 56.3% in DN group and 50% in DP group, respectively, with no significant difference (P> 0.05). Safety: Myelosuppression: Ⅲ-Ⅳ thrombocytopenia incidence of DN group 25% (8/32) was significantly higher than the DP group 10% (3/30) (P <0.01). Gastrointestinal reactions: The incidence of nausea and vomiting in DN group was 25% (8/32), significantly lower than that in DP group (76.7%, 23/30) (P <0.01) 32) was significantly lower than that of the DP group (20%, 6/30) (P <0.01). The incidence of grade III-IV renal damage in DN group was significantly lower than that in the DN group (3.1%, 1/32) P <0.01). Conclusion Docetaxel combined with nedaplatin and docetaxel plus cisplatin in the treatment of advanced non-small cell lung cancer has similar clinical efficacy. The toxic and side effects of DN are mainly myelosuppression. The DP is mainly gastrointestinal and nephrotoxicity. Clinical use, according to the patient’s individual differences to consider side effects, choose medication.